Executive Briefing

Executive Briefing

Leadership Briefing What Is TeamSTEPPS? An evidence-based teamwork system Designed to improve: Quality Safety Efficiency of health care Practical and adaptable Provides ready-to-use materials for training and

ongoing teamwork Mod 1 2.0 Page 2 TEAMSTEPPS 05.2 Why Use TeamSTEPPS? Goal: Produce highly effective medical teams who optimize the use of information, people, and resources to achieve the best clinical outcomes Teams of individuals who communicate effectively and back each other up dramatically reduce the consequences of human error Team skills are not innate; they must be trained Mod 1 2.0 Page 3 TEAMSTEPPS 05.2

Why Invest in TeamSTEPPS? Cost of TeamSTEPPS is minimal compared with savings Annual cost is approximately 98,000 lives and $17-29 billion Errors can be reduced by changes to the health care system, specifically by providing interdisciplinary team training Mod 1 2.0 Page 4 TEAMSTEPPS 05.2 What Can TeamSTEPPS Do for Us? Emergency Department1 After implementation of multiple medical team training programs:

After implementation of SBAR Improved observed team behaviors Enhanced staff attitudes toward teamwork Reduced observed clinical errors Mod 1 2.0 Page 5 Clinical Units in a Medical Center2

TEAMSTEPPS 05.2 to improve communication among clinical caregivers: Reduced rate of adverse drug events (from 30 to 18 per 1,000 patient days) Improved medication reconciliation at patient admission from 72% to 88% and at discharge from 53% to 89% What Can TeamSTEPPS Do for Us? Labor and Delivery Units1

Intensive Care Units2 After implementation of multiple After implementation of a teamwork strategies and tools: Mod 1 2.0 Page 6 A 50% reduction in the Weighted Adverse Outcome Score, which describes the adverse event score per delivery A 50% decrease in the Severity Index, which measures the average severity of each delivery with an adverse event

TEAMSTEPPS 05.2 Patient Daily Goals form to facilitate staff communication: A 50% decrease in mean ICU length of stay from 2.2 days to 1.1 days What Can TeamSTEPPS Do For Us? Interprofessional Training/Education1 After participating in an interprofessional TeamSTEPPS training during neonatal resuscitation in a simulated environment: Mod 1 2.0 Page 7

Nurses who challenged a scripted medication order error increased from 38% before the training to 77% after training The teams ability to detect and correct inadequate chest compressions increased from 61.5% to 84.6% after the training TEAMSTEPPS 05.2 What Can TeamSTEPPS Do for Us? Operating Rooms After implementation of a pre-op brief:

Mod 1 2.0 Page 8 Increased OR communication1,2 Increased administration of properly timed prophylactic antibiotics prior to incision from 84% to 95%1 Increased pre-op deep vein thrombosis prophylaxis prior to induction from 92% to 100%1 Better error avoidance: Pre-op brief revealed seven patients (3.3%) with previously unidentified severe surgical risks surgery cancelled1 A 16% reduction in nursing turnover rate2 A 19% increase in OR employee satisfaction2 TEAMSTEPPS 05.2

What Makes TeamSTEPPS Different? Evidence based and field tested Comprehensive Customizable Easy to use Publicly available Mod 1 2.0 Page 9 TEAMSTEPPS 05.2 What Will Our Teams Learn? Mod 1 2.0 Page 10 TEAMSTEPPS 05.2 How Does TeamSTEPPS Work? I. Assessment

Clearly define the need II. Planning, Training, and Implementation Plan to sustain the effort Train individuals Implement and test the strategies III. Sustainment Integrate into daily practice Monitor and measure programs Mod 1 2.0 Page 11 TEAMSTEPPS 05.2 What Do We Need To Make This Work? Clearly define the need Focus on enhancing teamwork and establishing a

Mod 1 2.0 Page 12 teamwork and safety culture Get support from senior leadership Allocate sufficient resources Personnel Time Resources Measure success Reward and reinforce teamwork TEAMSTEPPS 05.2 What Does Training Cost? Key to Table Figures $A = Trainer preparation costs: Trainers time x trainers hourly rate $B = Travel costs related to any of the train the trainer sessions $C = Trainer costs to conduct training: Trainers time x trainer hourly rate $D = Trainee costs: Number of staff to be trained x (number of training

hours) x staff hourly rate $E = Other training expenses: Food, senior leadership time for kickoff, etc. $F = Trainer costs for ongoing support: Number of areas participating x (hours of support) x trainer/coach hourly rate $G = Optional cost for staff time discussions: As normal course of business $H = Other ongoing support costs $I, $J, $K = Total: Estimated costs at bottom of each column Mod 1 2.0 Page 13 TEAMSTEPPS 05.2 What Does Training Cost? Trainer Mod 1 2.0 Page 14 Staff Other Costs

Preparing Trainers $A Conducting Training $C $D $E Providing Ongoing Support $F $G

$H TOTAL $I $J $K TEAMSTEPPS 05.2 $B How Do We Start? 1. Create a sense of urgency 2. Pull together the guiding team 3. Formulate a change vision and strategy 4. Communicate your vision for understanding and buy-in

5. Send trainers to one of the TeamSTEPPS National Implementation Regional Training Centers Mod 1 2.0 Page 15 TEAMSTEPPS 05.2 Training for the Guiding Team Training is available on a first come first served basis Visit AHRQs TeamSTEPPS Web site for more information and available courses Mod 1 2.0 Page 16 https://www.ahrq.gov/teamstepps/

TEAMSTEPPS 05.2 Backup Slides The following slides (1821) can support the briefing and may be integrated into slides 114 as appropriate. Mod 1 2.0 Page 17 TEAMSTEPPS 05.2 National Teamwork Initiatives The Accreditation Council for Graduate Medical Education and the Association of American Medical Colleges include aspects of communication, coordination, and collaboration in physician competencies The National Quality Forum included teamwork training, skill building, and teamwork interventions in Safe Practices for Better Health Care: A Consensus Report (2006 update)

The Joint Commission has increasingly included elements of teamwork in their National Patient Safety Goals and accreditation standards The Centers for Medicare & Medicaid Services included TeamSTEPPS in the 9th Scope of Work Mod 1 2.0 Page 18 TEAMSTEPPS 05.2 Importance of Communication Communication failure has been identified as the leading root cause of sentinel events over the past 10 years (Joint Commission) Communication failure is a primary contributing factor in almost 80% of more than 6,000 root cause analyses of adverse events and close calls (VA Center for Patient Safety)

Mod 1 2.0 Page 19 TEAMSTEPPS 05.2 What Does it Cost? Costs can be modified by obtaining materials and having trainers teach themselves Based on the National Implementation of TeamSTEPPS Project, we estimate that a Change Team member will spend 10% FTE (200 hours) on this effort Mod 1 2.0 Page 20 TEAMSTEPPS 05.2 Resources Available TeamSTEPPS resources include:

Three teamwork training curricula Course Management Guide Multimedia course materials TeamSTEPPS Implementation Guide Measurement tools Web site for updated resources and information:

Mod 1 2.0 Page 21 https://www.ahrq.gov/teamstepps/ TEAMSTEPPS 05.2

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